Document Detail

Functional mitral regurgitation predicts 1-year mortality in elderly patients with systolic chronic heart failure.
MedLine Citation:
PMID:  15919238     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM: Mitral regurgitation (MR) has been demonstrated to be a powerful predictor of adverse outcome in middle-aged patients with chronic heart failure (CHF). In this study, we sought to define the prognostic impact of functional mitral regurgitation in a population of elderly patients with systolic CHF.
METHODS: One hundred seventy-five outpatients aged >70 years with validated CHF and left ventricular ejection fraction <40% underwent clinical and echocardiographic evaluations at baseline. Mitral regurgitation was diagnosed by Color Doppler and quantified in 5 categorical values using a 0-4+ grading system. Outcome measures included 1-year mortality and hospitalization for worsening CHF.
RESULTS: The distribution of patients according to the 5 different degrees of MR detected at baseline was: absent=11%, 1+=31%, 2+=38%, 3+=16%, 4+=4%. The relationship between MR and mortality was direct and approximately linear (r=0.39, p=0.00001). The prevalence of death in the 5 subgroups was 0%, 7%, 15%, 45%, 57%, respectively. Multivariate logistic regression analysis showed that MR was the strongest predictor of death (OR 4.47, 95% CI 1.50-13.0), independently of the presence of diabetes mellitus, older age and larger left ventricular end-diastolic volume. No association was found between MR and hospitalization for worsening CHF (r=0.08, p=0.41).
CONCLUSIONS: This study establishes the direct and independent relationship between MR severity and one-year mortality among elders with systolic CHF. Conversely, MR does not provide useful information regarding the risk of subsequent hospitalization for worsening CHF.
Giovanni Cioffi; Luigi Tarantini; Stefania De Feo; Giovanni Pulignano; Donatella Del Sindaco; Carlo Stefenelli; Andrea Di Lenarda; Cristina Opasich
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of heart failure     Volume:  7     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-03-07     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1112-7     Citation Subset:  IM    
Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
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MeSH Terms
Disease Progression
Echocardiography, Doppler, Color
Follow-Up Studies
Heart Failure / complications,  mortality*,  physiopathology
Mitral Valve Insufficiency / complications*,  physiopathology,  ultrasonography
Retrospective Studies
Stroke Volume / physiology
Survival Rate

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